Thanks, Susiestar!

[GoingNorth]

I've been reading old posts where I saw you extolling the virtues of Lidoderm patches and Voltaren gel.

I got prescriptions for both of those from my doctor for my arthritis. It was that or more painkillers and the painkillers interfere too much with my quality of life at this point.

I got the gel and the patches and they really help.

Thanks again,

toK

 

[susiestar]

I am so glad they help you. I am constantly surprised that doctors don't rx at least the patches to more people. in my opinion the company is hugely missing out on several potential markets for these. My daughter ends up with sprains and torn ligaments from her frequent falls due to the epilepsy. Each time the doctor (whatever doctor either at ER or urgent care or her reg doctor) trots out the rx for hydro or oxy codone or even straight codeine or morphine. Not one time have they rx'd patches with-o us asking, and she would far prefer the patches. each time the doctor is surprised at the suggestion but happy to give the rx, esp once the realization that we would prefer the patches instead of rather than in addition to the other medications. I think that a LOT of people could be helped and a whole lot of pain medications could be avoided by using patches. But no marketing is done for them for this use or many others. Given the addiction issues, I would think they would be all over this, esp given the lectures the docs give each time they give the pain medication rxs.

I am so glad these are helping you, and I hope they continue to help. FYI, the patches are available in generic now which greatly reduces the price.

 

[GoingNorth]

I originally asked for the patches for costochondritis, which is an inflammation of the cartilage and nerves in the ribcage. Very painful. Vicodin wasn't holding the pain, so my doctor prescribed oxycodone. I took one tablet and fell in the bathroom. My legs just gave way and I got very dizzy. Vicodin makes me very loopy. Plus, I can't drive while taking it.

I have definite trigger points for the ribcage and it occurred to me that slapping a lidocaine patch on the trigger points might help. I got the generic ones. With the patches, Ibuprofen helps enough that I can function and don't need anything stronger. My only objection to them is that they feel awfully clammy when you first put them on.

The Voltaren gel is now out as diclofenac gel, but is still bloody expensive. It's the same thing. With the gel, I can take acetaminophen and it keeps the pain bearable.

My doctor will prescribe pain medications because she knows I'm responsible with them. Heck,I have to take Zofran generic with the pain pills in order to keep them down.

She prescribes them a month at a time and all I have to do is request that she fax in a prescription. I don't get the lecture with her.

The patches were originally developed for shingles, and the gel, oddly enough,is on-label for treatment of pre-cancerous skin lesions.

The problems I have with the dizziness and nausea really make taking oral pain medications a quality of life issue. I know that many people can take them without getting "high" from them, but I can't. I hate the way I feel on narcotics, plus all I can do is lay around when I take them.

I live alone and don't have anyone to take care of me while I loll in a drug-induced stupor

Anyways, thanks again for the tips. I do appreciate them.

 

[susiestar]

Why have they not done nerve blocks for the costo? I have it, as does Jess, and the nerve blocks are AMAZING and far more effective than any oral medication or topical medication. It isn't like an epidural though it sounds the same. LIdocaine and steroids are injected into the trigger pt and it calms the nerve for several weeks to months.

Given your issues with opiates, this would be a very viable option even if you couldn't tolerate th steroid part and just had the lidocaine part of the shot.

I cannot use the gel as I used NSAIDS for so many years at dosages that now make docs cringe that my body now treats them all as allergens. The whole cannot breathe, turning splotchy red deal comes from even an advil or an aleve. It is one reason I now see a pain mgmt doctor and had to turn to stronger opiates for pain control. I go for nerve blocks as often as possible because they make a huge difference.

Opiates don't really make me feel goofy or high and never have. It really bugged a few past docs and the nurse of the gp my husband sees. I am looking for a new one because this idiot kept booking beds at psychiatric hosps for me for medical issues like migraines and not wanting to pay for brand name medications if generics are available due to our strained budget - and no, I am NOT joking. SHe kept telling me that I needed to go for inpatient psychiatric treatment and giving the psychiatric hospital my info if I called with any problems or questions or if the doctor wanted a referral for something like physical therapy for me. She even flat out told the doctor she did it because only psychotic people have more than ten migraines a month. doctor won't fire her, so I fired the doctor. Sad because she is a really good doctor but not a good boss of this nurse, Know what I mean??

Anyway, talk to your doctor about the nerve block on that trigger point for the costo. It could mean a difference in your life that would be substantial.

 

[GoingNorth]

NO-ONE has mentioned nerve blocks for the costo, and I've had it since I was in my late teens.

I'd try the lidocaine without the steroids first as steroids do make me a bit wiggy. Not so much the injections, but oral steroids.

I was hospitalized for a suspected heart attack that turned out to be a new trigger point for the costo. Pain and spasms in my left chest, and pain and numbness down my arm. After a bunch of (mostly unpleasant) tests, it was determined that my heart was fine.

My costo is so bad that I actually get swelling along the affected ribs. it sucks.

I will ask my GP to refer me to a specialist for the blocks. Being free of the costo pain would be wonderful.

I want a referral anyways as I want to look into the 'base of the skull' injections for tension headaches. I have severe DJD in my neck and get horrible headaches.

Because I am also a migraineur, the tension headaches often "go bad" and turn into migraines. I understand that they are now doing Botox injections if the blocks help.

Right now I am on propranolol for the migraines and tolerating that OK so long as I get up slowly from laying down. I have Fioricet with codeiene. I can't take imitrex or similar due to risk of lowering seizure threshold with the AP I'm on. Can't change APs as so far this one isn't causing horrible side-effects.

The Fioricet knocks me out and I again have to take Zofran with it or it makes me puke. Plus, one can only take the Fioricet 3x weekly as the barbiturate in it is hugely addictive. I have to plan on being "off the air" for 24 hours if I take the medication as even though it knocks out the tension headaches and makes me sleep. It leaves me with a "hangover" for some time afterwards.

It's funny. I can take benzos in doses that would drop a draft horse, but I'm very sensitive to narcotics.

Right now, I've got half a Vicodin on board, a patch on, and some ibuprofen in my system and things seem to be under control. Of course, I'm still home for the evening.

When I was in the hospital, once they determined that it most likely wasn't my heart (waiting for the echo results), I got a shot of Toradol. I LOVE that stuff! I wish they'd come out with a version that could be used long-term. It knocks out headaches and "body pain" wonderfully.

In the ER, they gave me morphine and Phenergan. Still made me pukey. Then they gave me nitroglycerin which promptly threw me into a migraine and had them running around in circles thinking I'd had a stroke in addition to a MI as I have neurological signs with a migraine. It was a mess.

I did discover though that both the costo and the headaches got better once I went on thyroid medications. I have Hashimoto's Disease. My immune system attacked and destroyed my thyroid. I've also lost about twenty lbs though still have a long ways to go to reach my goal weight.

Did you have the injections done by your GP or by a specialist. I was diagnosed with fibro and costo in Germany many years ago. That was by a rheumatologist who basically ruled out everything else

 

[DammitJanet]

Wow GN....I was put in the hospital back on 05 with them thinking I had a heart attack and it was chosto. Or as the on call doctors referred to it "arthritis of your rib cage."

I have used the lidocaine patches before but dont have them now but do have the gel. I can only use the gel because I took large doses of Ketoprofen for over 3 years which sent my gut into major conflict. I now cant even take advil. If I get a headache I use one baby aspirin which I melt under my tongue.

I am actually considering ending pain management because of issues with my last appointment. If I cant be treated decently I might as well just not go. What ticked me off was they got ticked off because I didnt bring in my pill bottles when they would have been empty on that day anyway and they tried to lecture me about rescheduling my appointment when I had no way to get to the earlier appointment due to the car wreck. I also asked them to look at some damage I have due to the accident and they refused. That made me mad because two days before the appointment my leg had gone numb, it buckled and I fell backwards into a 4x4 holding up my porch. I have a huge bruise running all the way from my butt halfway up my back and they wouldnt even look at it. Can we say pill mill?

 

[GoingNorth]

Janet, it does sound like you are dealing with a pill mill. I know that when husband was in a hospital-affiliated pain management program that there were all sorts of non-drug therapies included.

Stuff like acupuncture, massage, physical therapy, counselling, etc. Sounds like your place just runs you in and out. Do you even see a MD or NP, or just PAs?

A red-flag for me about your place is that they haven't even addressed the constipation from pain medications. A "bowel protocol" was part and parcel of husband's pain management plan. As a result, he never had to deal with the problems you've had.

I wish you could find a different pain clinic in your area. I worry about you taking pain medications without proper supervision. A good pain clinic can come up with an indivualized "cocktail" of medications that takes care of the pain without side-effects (until you go on the big guns. husband had to quit driving when he went on Dilaudid) that affect your quality of life.

You should be followed by a bariatric specialist. husband didn't have a problem with overweight. Instead he had trouble keeping weight on that dated back to long before he got sick. He worked with a nutritionist to come up with an eating plan that he could tolerate that would keep his weight up. I know for a fact that help with weight LOSS was also offered by the clinic.

Pain control is only part of the picture. Pain management has to deal with the WHOLE patient to work properly.

 

[DammitJanet]

I did manage to get them to rx me amitiza or however you spell it but I had to ask about 4 months in a row. I kept seeing that new commercial on TV for something starting with a L...maybe Lorzee...something like that. I am bad with remember things off TV...lol.

Finally after telling about 3 people that I was having a whole lot of problems and OTC stuff simply wasnt working they finally agreed to try this amitiza stuff.

I am thinking of trying to change to the place Cory just got into. They actually did a physical exam on him and were astonished when they found out no one was attempting to do anything for him. Not so much just pain control but he has almost no range of movement in his neck anymore and the place I go to told him that there was nothing wrong with him when he tried to go there even though he had xrays showing his back. This new place sent him for MRI's and now he has to go about 80 miles away to see the main clinic of this place where the lead doctor is so he can diagnosis him with anything else he has other than the Springle's and the probable scoliosis. They believe he has ankolyzing spondolytis.

I have begged my doctors to check me for other forms of arthritis which could possibly be treated with something else. I would give my right arm to never take another pain medication again.

In fact, I am seriously thinking of going off of them anyway just to see if I get worse, better or indifferent. I do take the dilauded but its a 24 hour release form that I take at night and cant feel physically at all. I assume it does something for me because I believe I would have hurt much worse during the car accident. But again, what truly bothers me is that this pain clinic never puts hands on me to see if they can tell anything is wrong even when I tried to tell them I was in a car accident, my leg went numb and I fell into a pole bad enough to leave a bruise that is over 18 inches tall by 10 inches wide.

 

[GoingNorth]

Janet,in an ideal situation, you shouldn't "feel" the pain medications once you get used to them. That's what good pain management works toward.

When husband went on dilaudid with fentanyl for breakthrough pain, it was towards the end of his life. At that point, he had to sacrifice function for pain control.

Up to that point, while increasingly disabled, he had full mental function on his medications. Part of his pain management on the heaviest duty stuff was the use of stimulants to counteract side effects.

Your medications shouldn't be interfering with your quality of life. You have to take control of your pain, be an informed patient, etc.